A patient-level simulation based on English clinical trial data projects that AI-assisted colonoscopy could be cost-effective and cost-saving for symptomatic colorectal cancer referrals, despite probabilistic decision uncertainty. The analysis uses modeled lifetime pathways rather than a head-to-head economic trial. The core value proposition is potential efficiency gains in detection and workflow, translating into fewer downstream events and avoided costs over time. However, the simulation approach also highlights that real-world operational impacts—deployment costs, false-positive burdens, and training—still need continued monitoring. For payers and healthcare operators, the study provides an economic signal to support staged rollout decisions while collecting local performance and utilization data.